Saturation be damned

Night time reading

I love interacting with this informed and educated community of ours who take responsibility for own health, read and interpret scientific articles, ask intelligent and incredibly tricky questions and look at the world through a prism of human evolution. It’s really really cool. I also don’t own a television or read newspapers. I know, I am missing out on the vital information on the recent exciting advances in the field of laundry detergents, easily foldable exercise equipment and female hygiene products. But I’ll take my chances.

So when I was approached recently by an Australian reporter to comment on why saturated fat might not be as bad as everyone thinks, I was temporarily stunned. Everyone still thinks that? An hour-long lunch outside in the company of co-workers brought me back to reality. Listening to the less-than-lithe lady lecturing a younger employee that “pasta is perfectly healthy as long as you avoid creamy sauces and stick with tomato-based ones and add psyllium husks to increase fibre” plunged me back to earth from the AHS12-induced heights.

Oh boy. On this planet, margarine is still a health food.

So I thought I’d write down some thoughts on fats, why we still need to talk about them, the strength of evidence and where we go from here. The article ended up being published at The Age and I was amused to see our hour-long phone conversation and the exchange of several emails with attached studies reduced to one sentence quoted from me, but I am not complaining since I think the article was quite well-balanced and hopefully gives people some food for thought. Here is the link.

If you are totally new to all this, I recommend that you read my post on fat basics and the slightly more complicated polyunsaturated fat primer.

Don’t all scientists and doctors agree that saturated fat is bad?

My main gripe with conventional advice to reduce saturated fat in the diet is that it makes it sound that everyone in science and medicine agrees that it is the right thing to do. They say “scientists” and you imagine a group of nerdy-looking men and women in lab coats and glasses with clipboards, all nodding in unison: “Saturated fat will kill you”.

Bad cow, bad!

Sorry, no. Far from it. In the year 2012 we still run trials on dietary fat and its effect on mortality, cardiovascular disease and weight. In fact, a Pubmed search on “dietary fat” yields close to 700 article from 2010 to present date.

If “saturated fat will kill you” is a done deal why do all these folks get research grants and waste years of their life on the pointless pursuit of the truth that has long been discovered and incorporated into every government-led nutrition advice?

And yet, the consensus is farther away than ever. Nutrition and Metabolism Society publishes critiques of the American Dietary Guidelines, as well as scores of papers on the subject. Then there is THINCS, The International Network of Cholesterol Skeptics, which really sounds like an evil mad scientist organisation from a Bond movie, but in fact has respected members like a biochemist Dr Mary Enig and a scientific researcher Dr Uffe Ravnskov.

Not to mention a fine gathering of clinicians, scientists, nutritionists, researchers, physiotherapists, bloggers at Harvard Law School this year for 2012 Ancestral Health Symposium, most of whom seemed to think that bacon is rad and margarine is bad.

Can you refute XYZ study and the rest of the body of evidence on saturated fat?

Yawn. I have no intention on memorising every study conducted in the last 50 years, no matter how bad or good they are. We have been eating fat, lard, meat, eggs, butter, ghee, coconut oil for thousands of years. I think the burden of proof lies on those who say that these traditional foods have been our silent killer all along. All I can do is to politely present the vast body of scientific evidence that does not support the lipid hypothesis (YES! IT IS STILL A HYPOTHESIS!)

Sarcasm alert. Lipid Hypothesis 2.0 = we have come to realise that total fat intake has no bearing on heart disease or weight (sorry! Our bad!) But it’s all about the type of fat. There are only 2 types of fat: saturated (=evil, comes from animals, eating animals is bad, you immoral cruel self-serving glutton) and unsaturated (=pure good, comes from vegetables, like cottonseed, soybean, canola and sunflower, botany be damned). Substituting unsaturated for saturated fat is the real reason why we are healthier, thinner and fitter than thousands of generations of traditional cultures because they couldn’t work out how to get 10% of their daily calories from PUFA, suckers.

 

He needs to be told how unhealthy he is from his 40% SAFA intake. Those coconuts will kill you, buddy! (Source: http://www.thatpaleoguy.com)

Several studies have shown improvement in CV markers and mortality when saturated fats were replaced with PUFA. Regardless of how good/bad sat fats are, shouldn’t we make the substitution just in case anyway?

This is a very common reasoning from many educated doctors and academics. They are now aware that sat fats are not much of a problem. Great. But what’s the harm in tinkering our diets if all we have is improvement, right?

Wrong.

I have a real problem with a blanket advice to increase PUFA in general as if they are all the same. PUFA are not all created equal, they have different physiological functions and effects on the body! (go back to basics). At the very least they should be differentiated into omega-3 and omega-6. However, even that’s too simplistic.

If you are planning on dividing fats on the basis of the biochemical structure and biological function, you have just only scratched the surface. Behold! All saturated fats are actually not the same either. Lauric fatty acid is metabolised differently and has different effects on serum lipid profiles than stearic. Even omega-3 are not a homogenous group (gasp!). The intake of the shorter-chained ALA (alpha-linolenic acid) does not come close to providing the same benefit as the long-chained DHA due to inefficient conversion.

Jacobsen’s analysis of 11 cohort studies, quoted in the article as the final proof of the miracle qualities of PUFA,  showed that substituting PUFA for SAFA seemed to reduce CV events and mortality. However, simplification, as usual, can only take you this far. The analysis lumped omega-3 and omega-6 PUFA together and did not take into account the deleterious effect of trans fatty acids separately from SAFA.

“Linoleic acid selective PUFA interventions produced no indication of benefit but rather a fairly consistent, but non-significant, signal toward increased risk of coronary heart disease and death. ” (Kuipers ER al, 2011, hyperlinked above)

That’s what happens when you simplify a complex concept. Why? Because the public are so dumb they won’t get it? Because 2 types of fat is quite enough to remember? And to make things even more visually and conceptually appealing let’s represent them as ying and yang, bad and good, dark and light?

So you have some studies, “they” have some studies. How do lay people know who to trust?

As much as I respect Evidence Based Medicine, I am well aware of its limitations. You can pull apart every study, point out the confounders, small sample size, confirmation bias, lack of double-blinding, the grant approved by a completely impartial third party with key investments in related area. Let’s not reduce the process to “Mine is bigger than yours.”

Nothing in biology makes sense except in the light of evolution“. Repeat this 5 times before going to bed every night.

How much omega-6 was available in our diet as Homo sapiens for 2 million years up to the advent of industrial processing? How much oil can you get out of a soybean without the benefit of extraction chemicals?

Aaaaaaah! Would you just tell me how much PUFA/SAFA/Carbs I should be eating?

Talking about macronutrients (fatty acids, carbs, etc) is useless unless it applies to food. If the advice to increase PUFA translates into “eat more fish” I will be the first one to shout it from the rooftops! But what if it translates into “eat more peanut butter”? Still PUFA! But are you going to get the same benefits? You don’t need to read an insightful review by Christopher Ramsden on omega-3 vs omega-6 to know that peanut butter ain’t gonna make you healthier than salmon. But sometimes we really really want to believe it. And deluding ourselves is oh so easy when somebody in a position of authority gives you the green light.

Yum

Focusing too much on macronutrients is what allowed abominations like “low fat banana bread” to become a healthy morning tea snack. The “reductionism” approach has successfully indicted natural foods such as eggs, coconut, avocado, butter. At the same time we have low fat sausage rolls, sugary cereal, margarine and other foods devoid of any nutrition, riding on the coat tails of the lipid hypothesis 2.0.

One of the benefits of using the evolutionary approach is that it allows you to make rational decisions about your life choices without having to double-check them with Pubmed. And it doesn’t involve re-enactment of Paleolithic times, although heaven knows, I find some modern social conventions really tedious (like people requesting to know how I am going on a Monday morning prior to my first cup of coffee). As the opponents of the Paleo approach correctly point out, we don’t really know what our ancestors ate. But I sure as hell know what they DIDN’T eat: excessive amounts of sugar, grains, seed oils and other industrially produced food-like substances. Not even almond flour cupcakes. Sorry.

Regulating your fat intake is easy: eat fish, seafood, meat (preferably grass-fed), eggs, some nuts, seasonal fruit and veggies.

Go back to eating food, not labels.

“Something is rotten in the state of Denmark…”

Edwin Booth as Hamlet, 1870. Source: Wikimedia Commons

Ah, Marcellus, something certainly is not right in the fair state of Denmark as of last Saturday. In case you have missed the hullabaloo in Europe, a new surcharge, colourfully dubbed by the press “the fat tax”, took effect in this small Scandinavian nation on October 1, 2011. As usual, it didn’t take long to generate a massive media hysteria. After reading over 20 reports on the internet and getting thoroughly confused by factual contradictions I managed to pull out the following info:

  • the tax applies to all foods containing >2.3% saturated fats
  • each kg (=2.2lbs) of saturated fat will collect a surcharge of 16 kroner (=$US 2.87)
  • the tax is introduced as part of obesity-fighting measures and $218 million US dollars expected to be raised will go towards preventative health
  • the goal of this intervention is to reduce saturated fat intake in Denmark by 10% and butter intake by 15%

As this article eloquently puts it:

“The new tax will be levied on all products including saturated fats, from butter and milk to pizzas, oils, meats and pre-cooked foods…”

Interestingly, Copenhagen Post was seemingly concerned about other foods items:

“The biggest price increases will be seen on fatty staple foods like butter, oils and high-fat dairy products like whipping cream and crème fraiche…”

Let me for the moment pass over the ridiculousness of the sentence which lumps an ancient traditional product like butter together with pizza and pre-cooked food-like-substances-in-a-box. To be perfectly honest, I know very little about Denmark. My impressions largely consist of Vikings, dams, environmental activism, Princess Mary, beautiful images of Copenhagen and yes, butter. So after 4 days of self-imposed post-exam laziness I got my iPad out and started reading up on the Danish health, economy, agriculture and food consumption.

Warning: a few graphs coming your way.

First a few Denmark trivia facts (Source: NationMaster.com country statistics)

1. The population estimate in Denmark today is over 5.5 million with population density of 129 per km2

2. According to the latest WHO data (2008) the actual obesity rate in Denmark is 18.2% not 10% as widely reported

3. Danish Big Mac Index is the fourth highest in the world at US$4.49

4. An average Dane goes to 6.1 doctor consultations a year

5. The life expectancy at birth is 77 for men and 81 for women, lower than in Finland, Sweden and even Australia (in your face, Danes! Even with our diabetes-crippled legs and sky-rocketing obesity rates we live longer!)

6.The average tax burden is 46%

7. Denmark is widely considered one of the happiest and least corrupt countries on the planet (not sure how it tallies with both #5 or #6 but good for them)

The World Health Organization updates a regular Non-Communicable Diseases profile for each country. You can look Denmark up here. Allow me share a few more interesting facts from that profile.

I was surprised to note that 24.6% of Danes still smoke cigarettes daily, a figure much higher than 16.8% of smokers in Australia or 15.6% in the US. If I had to choose a public health intervention…

Let’s take a look at the trends of some chronic disease markers as defined by the WHO: BMI, fasting blood sugar, systolic blood pressure and total cholesterol.

Blue line = men, orange line = women

Both average BMI and fasting blood sugar have been steadily climbing. That’s clear enough according to public health warriors. Butter -> extra calories -> overweight -> diabetes. This is how the conventional wisdom goes, n’est ce pas? Strangely enough, both systolic blood pressure and total cholesterol have decreased in the same period of time:

Obviously, this is just observational data and it doesn’t offer any causative relationship. Correlation does not mean causation (repeat this statement like a mantra if you work in public health). It could be that while the Danes still enjoy their high-fat dairy and meat their busy physicians prescribe them lots of antihypertensives and statins. If only we could get the Danish public to reduce their wicked butter and cheese habits, increase their intake of whole grains and vegetables and bingo! we would see those numbers plummet, life expectancy jump up, muffin tops melt away, relieved cows will be doing a happy dance.

Luckily my curiosity didn’t stop there. I wanted to see just how gluttonous the Danes apparently are. (Clarification: I don’t think they are gluttonous. As far as I’m concerned their government tells them that they are. I’m just following that logic). Statistics Denmark  kindly provides all sorts of fascinating data free of charge. I pulled out some food consumption data in Denmark and ran a comparison between the years 1990, 2000 and 2009. And in case you are wondering, I totally cherry-picked my data, using only 13 out of available 55, just because I found them most illuminating but you can look up the raw data yourself here StatBank Raw Data. Click on the chart for better resolution.

 

Human consumption kg per capita per year

Turns out that our butter-loving Danes are not eating that much butter after all: only 1.9 kg per person per year. So a desired 15% decrease in butter intake will result in…drum roll…1.6 kg per person. They consume 4 times more margarine than butter however thankfully their margarine consumption has also been declining in the last 20 years. What else can we see? Overall reduction in meat consumption since the 1990: 105.2kg to 83.6 kg. They certainly eat more beef and veal (18.8 → 24.8) but almost halved their pork consumption (64.2 to 35.8). Offal consumption is less than half of what it was even 20 years ago. In keeping up with the low fat trend, whole milk dropped 65% while white water, pardon me, skim milk jumped up over 400%. We have some increases in wheat flour and other grains, including a dieter’s staple, oats.

The other numbers that we are all dying to see are of course soft drinks (soda), industrial seed oils, sugar and the one I was always wondering about, a humble coffee shop favourite, the danish (do they even eat those?).

Overall Denmark looks like an awesome country: rich history, friendly people, gorgeous architecture. It’s a shame that their outgoing government in the desperate show of “we really care” brought a ridiculous tax which promises so much but delivers nothing other than panic at the supermarkets and more guilt about eating butter. I’d still love to come for a visit but next time I’ll bring my Lurpak from Australia.

Fat, glorious fat. Part I

I address this subject with a certain trepidation, as there is a thin line between making science accessible and on the other hand unforgivingly oversimplifying difficult concepts.

In this first post of my Fat series I’d like to go back to the basics of fat biochemistry. If you have spent enough time in lecture theatres scribbling down the chemical formulae for beta-oxidation of fats, feel free to take a nap. If you don’t know your linoleic from your myristic, here is your chance!

Fats have received a pretty bad rep over the years. One of the most common misconceptions comes from the word itself: fat! Fat is bad! Fat makes you fat! We see these images in the media: an obese person gorging themselves on something that is considered unhealthy. You can see the glistening cheeks and mouth, thick fingers dripping oil, fat from the stomach traveling directly to their thighs. Your inner Puritan is horrified, judgement is formed in your mind even before you have consciously acknowledged it to yourself.

The media do a great job perpetuating the myth of “saturated fat clogging your arteries”. Here is a recent addition to the shock and awe campaign on fat, courtesy of the British government. As much as you want to imagine your blood vessels as pipes where you are pouring soft sticky fat mass every time you eat a burger, it bears absolutely no resemblance to what actually happens.

Fats, or better put fatty acids (FAs), are a diverse family with its own overachievers and black sheep. We mostly think of fats as something that provides calories: 9 calories per each gram of fat, the highest value out of all other macronutrients. They tell us that’s what makes us fat. But the caloric value of fats is only important if they are actually “burned” for energy. Dietary fats are used for much more than just providing calories: they are a vital component of the cellular membranes for each of the 50 trillion cells in the body. When you don’t receive enough cholesterol in your diet, your liver makes some by using the saturated fats from your food (why would it do that? Doesn’t it know that cholesterol causes heart disease?). Your brain is 60-80% fat and every neuron in your body has a fatty insulating myelin shield.
Most of us though think of fat as this stubborn orange-peel substance on our thighs, sticky soft sludge pouring through our arteries or the thick yellow deposit packing our tired liver.

So how can something so good be so very bad?

Let’s start with deciphering the common terms surrounding fats.

Triglyceride is the term commonly interchanged with fat, it consists of 3 fatty acids on glycerol backbone. Most dietary fats come into the body in form of triglycerides. Just like other animal fat, our own fat is also stored in triglycerides.

In biochemistry fatty acids are classified on the basis of saturation. The fatty acid is called saturated if carbons in its chain have a hydrogen atom at each one of the 4 available bonds. This arrangement makes for a chain which is straight and stable like a string of pearls. And because these can be easily packed together, they are solid at room temperature (think a block of butter).

An unsaturated fatty acid has at least one carbon which is missing a hydrogen. This makes the carbon form a double bond with its neighbour. Monounsaturated FAs have only 1 double bond in their chain. Polyunsaturated have obviously more than one. The double bonds in the chain give the fatty acid some interesting properties. Firstly, they are more vulnerable to the free radical attack, or oxidation, which can make them rancid. Secondly, double bonds change the shape of the fatty acid molecule: instead of a string of pearls you get a chain with a kink or two. This lowers the melting point of unsaturated fats, making them liquid at room temperature.

Here is what we are up to at the moment.

Fatty acids can be further classified by their length. Most of the saturated fat coming from animal sources is in the form of long chain saturated fatty acids: LCSFA, with >12 carbons each, for example palmitic, myristic and stearic. The carbon-carbon bond has the potential to release energy, which makes these FAs a very effective source of fuel. This is also the way your body stores them in your fat (adipose) tissue.

I think it’s important to understand the storage issue. We are so used to seeing stored fat as an inconvenience or an indicator of disease that we have forgotten why it is there in the first place. It is there to be burned. Think of it as fuel for your fireplace. You don’t collect dry timber and then get annoyed that it takes up too much room in your backyard. It is their for one reason only: to use it for energy (warm up your house) when there is a dire need. Humans have evolved to have extra energy stored away for further use.

Next question: when you stock firefuel for winter, do you use timber or rubber tyres? Both will burn, both will give off heat. But you will still choose something which is more benign and will not poison your entire family with fumes. If saturated fatty acids are so very dangerous, does it make sense that our body will carry a toxic load which will “clog your arteries” the moment it is released into the bloodstream. The fact that we have evolved to store saturated fats should be the first clue that they are the preferred source of energy and that the body considers them harmless.

If you are still with me, congratulations, you have high tolerance for dry science. Let’s plow along. Next we have MCSFAs, or the medium chain saturated fatty acids (the more common abbreviation is MCTs for medium chain triglycerides). They have between 8-12 carbons in their chains and the major dietary sources of those are breast milk (estimates range from 10-25%) and tropical oils (coconut oil and red palm). Lauric acid is a common example of a medium chain fatty acid. Unlike LCSFA, which are transported via lymphatic system in little vehicles called “chylomicrons”, MCTs travel via the portal vein from the intestine directly into the liver where they are preferentially used to form ketones. This is interesting because the conventional wisdom tells us that ketosis is always bad. So it’s kind of strange that a newborn baby would naturally receive a load of fat which encourages ketone production. Add to that the fact that your brain functions just as well (or maybe even better) on ketones and that your heart likes them as well, and there is another myth busted.

Finally, the SCSFA are obviously the short chains. Butyric acid is predictably enough in butter. But overall the dietary sources of these are very few. However, your intestinal bacteria happily produce them through fermenting fibre. Like MCSFAs they go straight to the liver.

If you are a male and therefore likely a visual learner, here is an updated pic :

Monounsaturated fatty acids, MUFA, (like oleic acid) are considered healthy by conventional standards. I, for once, agree with their assessment but for a completely different reason. The lipid hypothesis proponents support oleic acid because of their love affair with olive oil. I find it hard to believe that olive oil must be an essential part of our diet, mainly because there are plenty of regions in the world that do not naturally grow olives and somehow are still doing ok. However, monounsaturated fatty acids make up a big portion of animal fat, as much as 44% in pork lard, so it makes sense that we have evolved to process them. So if you want to increase monounsaturated FAs in your diet, fatty chunks of meat will get you much further than a tablespoon of olive oil on your salad.

Finally we come to polyunsaturated fatty acids, PUFA. They are subdivided into omega-3, omega-6 and omega-9 by the position of their first double bond if you count from the methyl (or omega) end of the chain. The FA with the first double bond in position 3 is therefore omega-3 PUFA and so on.

Animals do not tend to store large amounts of polyunsaturated fatty acids, mainly because they are not a very good source of energy. Therefore traditional animal fats are quite low in PUFA. Fish products are widely promoted for their PUFA content but while the relative PUFA composition are high compared to SFA, it is still a minuscule number in absolute terms. “Vegetable” oils (if you believe that seeds are from the same family as, let’s say, carrots) come on the top of that list. You have to eat 900 grams of smoked salmon to get the same amount of PUFA as in 1 tablespoon on sunflower oil kindly provided by the industrial processing technology. All PUFA tend to be lumped together in one big “healthy” basket but there are significant differences in their effect on the body.

To finish off just a quick summary of fat composition of common foods. Click on the table for better resolution.

Source: Wikipedia

And here is an updated diagram for you to memorise before the next post. Consider this your homework.

In the next post I will go a little deeper and talk about the “essentiality” of omega-3 vs omega-6. I will also address some clinical implications, health claims and health myths. Now go and have some fat!

Edit: a few errors which I blame on the brain fog commonly experienced after a hospital shift…

Moment of truth: quiz answers

If you haven’t done the quiz yet, what are you waiting for?

Aaaaand… drum roll… here are the answers!

1. Predominant fat in lard is monounsaturated. Yes, just like in olive oil. The composition of lard is as follows:
Saturated fat – 38-43%
Monounsaturated fat – 47-50%
Polyunsaturated fat 6-10%
It is a common misconception that animal fat = saturated fat. Most animal fats like lard or beef tallow have loads of monounsaturated fatty acids. Even butter contains around 30%. In addition 12-15% of saturated fat in lard is in form of stearic acid, which is converted by the liver to oleic acid( = more monounsaturated fat!).

2. Saturated fat consumption has decreased over the last 100 years.
According to this paper, published in the American Journal of Clinical Nutrition, saturated fat consumption in the US reduced from 16.6% in 1950-1959 down to 11.8% in 1980-1985. At the same time period the number of obese people has increased from 9.7% to 35% in women (33% in men).

3. Triglycerides are blood fats measured when you have a cholesterol test or a lipid profile test. It is very tempting to reason that fat in the diet raises fat in your blood. Sounds so simple and logical? But… The diet component most responsible for high triglycerides is carbohydrates. Consumed in excess, they get converted in the liver into triglycerides and transported to fat tissue for storage. The process is called “de novo lipogenesis” (new fat formation). Dr William Davies, a cardiologist from the US, describes it well here.

4. HDL is sometimes called “good cholesterol” and we are advised to eat foods which increase HDL to reduce our risk of heart disease. Low carb diets are found to raise HDL.

5. Glycemic index classifies carbohydrates by how much they raise blood glucose. We are told to stick to low GI foods for weight loss and diabetes management.
Baked potato – 101
“Frosties” – 55
“Peanut M&M’s” – 33
Muesli bar with dried fruit – 61
Super supreme pan pizza – 36
Eggs – 0
It seems blindingly obvious that GI system has major flaws as nobody in their right mind would consider M&M’s healthier than a potato. Eggs, beef, lamb, pork and other animal products have a GI of zero.

6. Cholesterol levels are tightly regulated in our bodies as this substance performs many vital functions. Up to 80% of cholesterol is synthesized in the body with 20% coming from dietary sources. When you reduce dietary sources of cholesterol, your cells try to increase their own cholesterol production to make up the difference. 

7. Our heart prefers fat in form of fatty acids as its main fuel source. Ketones, which are formed when the body burns fats, make up around 1/3 of the heart’s requirements. During fasting conditions, they provide up to 60-70% of the heart’s energy.

8. Vitamin A (retinol) is a fat-soluble vitamin essential for growth and repair, healthy bones and teeth, good eyesight, thyroid and immune system.
Vitamin A concentration in mcg for 100 g:
Liver 23000
Full fat milk 28
Butter 895
Sweet potato 700
Eggs 200
Carrots 8000
Carrots and sweet potatoes are traditionally advised as a good source of vitamin A. However vitamin A in plants is in the form on beta-carotene which has to be converted to retinol at a ratio of 6:1. In addition, your body needs fat to absorb vitamin A. So slather some butter on those veggies!

9. It is a common misconception that your body needs a constant top-up of carbohydrates to keep the bloods sugar up. If I could have a dollar for every time I heard someone say: “My blood sugar is dropping after my gym session. I better get a Gatorade/piece of fruit/cereal bar”. Somehow I don’t think that our ancestors were munching every 3-4 hours to avoid a blood sugar drop. Any biochemistry textbook will tell you that our body has several hormones, the job of which is to keep your blood sugar up. They do it by switching to fat-burning for energy, releasing glycogen (stored form of glucose) into the blood and using ketones to provide energy for the brain. Muscle protein is spared for as long as possible.

10. Saturated fats and trans fats are often lumped together although they have vastly different structure and effects on the body. The only thing they have in common is that they are solid at room temperature. Trans fats are highly processed vegetable oils, hydrogenated to resemble butter. They have been linked to obesity, heart disease and cancer. Mary G. Enig, a renowned expert in lipid biochemistry, gives an excellent explanation on fats here.

So how did you go? Please send me some comments with your thoughts: what you knew, what surprised you, what you want me to cover in greater detail.

I am still working on Resources page but I promise to get it going soon.

Consider yourself a nutrition expert? Take a quiz and find out!

When it comes to nutrition and weight loss, we are all experts. Thanks to Women’s Day, Men’s Health, body building sites and your Sunday paper, everyone has an opinion. Now is your chance to find out how much you actually know. The questions are based on basic biochemistry of human metabolism and therefore are not somebody’s point of view. They are simple hard facts you can find in any biochemistry or endocrinology textbook. Good luck!

1. The predominant fat in lard (pork fat) is:
A. Saturated
B. Monounsaturated
C. Polyunsaturated
D. I only buy margarine

2. Saturated fat consumption in the 20th century has:
A. Increased
B. Decreased
C. Unchanged
D. I haven’t seen saturated fat since I was 5

3. What component of the diet raises blood triglycerides the most?
A. Carbohydrates
B. Fat
C. Protein
D. I have never had a cholesterol/lipid blood test and have no idea what you are talking about

4. What is the effect of low-carb diet on HDL (“good cholesterol”)?
A. Increases HDL
B. Decreases HDL
C. No change
D. Low-carb diets are a fad and I will never try one

5. Estimate the glycemic index of the following foods (guess to the nearest 10 or choose low/medium/high):
A. “Frosties” breakfast cereal
B. Boiled potato
C. Eggs
D. Peanut M&M’s
E. Muesli bar with dried fruit
F. Super supreme pan pizza

6. Most of the blood cholesterol comes from your diet:
True
False

7. What is the preferred fuel for the heart?
A. Carbohydrates
B. Fat
C. Protein
D. Love

8. Which foods contain the most Vitamin A:
A. Carrots
B. Milk
C. Eggs
D. Liver

9. What happens in your body if you don’t get a carbohydrate fix 4 hours after your last meal? (in a healthy individual)
A. You go delirious and slip into a coma
B. You start burning your hard-earned muscle undoing all the work in the gym
C. Your body activates hormones which start burning body fat for energy sparing muscle proteins
D. This travesty has never occurred since you always carry a cereal bar for such occasions

10. What is the difference between saturated and trans fats?
A. There is no difference, they both cause heart attacks
B. There is no difference as they are both solid
C. Trans fats are man-made by hydrogenation, saturated fats are abundant in nature
D. I don’t know but this quiz has made me hungry

Answers in the next post!